Reimbursement Request Form

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Specify if you would like a check or Venmo payment
Attach up to 3 files/pictures/scans of all receipts and supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
Questions? Please e-mail our treasurer at Treasurer1@generalwaynepto.org

Full Name

Request Venmo or Check*

Venmo user name and last 4 of Phone number

Skip if getting a check

If getting a check for Reimbursement mailed or dropped off at School

skip if getting Venmo

Total Amount Requested for Reimbursement/Payment:

Committee/Event*

Description/Purpose:

Attach Receipt/Invoice #1

Attach Receipt/Invoice #2

Attach Receipt/Invoice #3

Date Check/Venmo Needed (please allow at least 1-2 weeks if possible):

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Specify if you would like a check or Venmo payment
Attach up to 3 files/pictures/scans of all receipts and supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
Questions? Please e-mail our treasurer at Treasurer1@generalwaynepto.org